Brandi Tyson Watson, FNP-C – Surgery Physician

Key facts

NPI: 1659934826
Entity type: Individual (NPI type 1)
Primary specialty: Surgery Physician 208600000X
License: RN139826 (GA)
Practice address: 604 E Long St Ste a
Claxton, GA 30417-5914
Phone: (912) 739-7710
NPI assigned: Apr 15, 2019
Sex: Female
Sole proprietor: No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Emanuel County Hospital Authority Surgery Physician · Swainsboro, GA · NPI 1003221243

Medicare reassignment NPD GA · SURGERY
Emanuel Prompt Care Urgent Care Clinic/Center · Swainsboro, GA · NPI 1487484820

Medicare reassignment NPD GA
Emanuel County Hospital Authority Rural Acute Care Hospital · Swainsboro, GA · NPI 1235129214

NPD
Emanuel County Hospital Authority Clinic/Center · Swainsboro, GA · NPI 1962639807

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20190906000312	GA	Practitioner - Nurse Practitioner	3971832635	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
RN139826	GA	MD	Surgery Physician

Practice roles

Organization	Specialty	Status	New patients
Emanuel County Hospital Authority	Surgery	Current	Accepting new patients
Emanuel County Hospital Authority		Current since Aug 1, 2019	Accepting new patients
Emanuel County Hospital Authority		Current since Aug 1, 2019	Accepting new patients
Emanuel Prompt Care		Current since Sep 23, 2024	Accepting new patients

Locations

400 Cedar St
Metter, GA 30439
Phone (912) 685-1726

305 Kite Rd
Swainsboro, GA 30401
Phone (478) 237-2144

5 Medical Office Way
Swainsboro, GA 30401
Phone (478) 237-2238

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

Interoperability endpoints

Direct secure messaging: surgicalassociates@sa.azalea.phimailbox.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Surgery Physician	208600000X	RN139826	GA	Yes

Addresses

Primary practice location

604 E Long St Ste a
Claxton, GA 30417-5914

Mailing address

198 Almond Rd
Metter, GA 30439-7367
Phone (912) 536-1882

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	surgicalassociates@sa.azalea.phimailbox.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 27, 2023.

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659934826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 ALMOND RD",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304397367",
            "telephone_number": "912-536-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E LONG ST STE A",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304175914",
            "telephone_number": "912-739-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "BRANDI",
        "middle_name": "TYSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "RN139826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "surgicalassociates@sa.azalea.phimailbox.com",
            "affiliation": "Y",
            "address_1": "604 E Long St Ste A",
            "city": "Claxton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304175914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Claxton, GA

All providers in Claxton, GA · Surgery Physician in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.